Probiotics with L. Casei Ease Kids' Eczema Symptoms

clinical-trial PMID: 29117309

Probiotics with L. Casei Ease Kids' Eczema Symptoms

Quick Summary: This study tested a probiotic mix including Lactobacillus casei on children with moderate atopic dermatitis (eczema). Over 12 weeks, kids taking the probiotics saw their eczema symptoms drop by 83% on average, compared to just 24% for those on a placebo. They also needed fewer steroid creams to control flare-ups, making it a promising add-on to standard treatments.

What the Research Found

Researchers discovered that a daily probiotic blend helped reduce eczema severity in young patients. The key measure was the SCORAD index, a scoring system that rates eczema based on redness, itching, and skin dryness—think of it as a simple way to track how bad the skin condition is.

The probiotic group improved by an average of 19.2 points more on the SCORAD scale than the placebo group (with a 95% confidence interval of -15.0 to -23.4; p-value less than 0.001, meaning the results are highly reliable).
In percentage terms, symptoms dropped 83% (95% CI: -95% to -70%) for those taking probiotics, versus only 24% (-36% to -11%) in the placebo group.
Kids on probiotics used topical steroid creams on just 7.7% of their treatment days (161 out of 2,084 days), compared to 10.8% (220 out of 2,032 days) in the placebo group. This cut their odds of needing steroids by about 37% (odds ratio 0.63; 95% CI: 0.51 to 0.78).
No side effects were reported, so the probiotics were safe and well-tolerated.

These findings show the probiotic mix, which includes Lactobacillus casei, could help manage eczema without relying as much on steroid creams.

Study Details

This was a solid scientific test called a randomized, double-blind, placebo-controlled trial, meaning participants were randomly assigned to groups, neither kids nor doctors knew who got the real treatment, and a fake pill (placebo) was used for comparison. It ran from March to June 2016 at a skin clinic in Alicante, Spain.

Who was studied: 50 children aged 4 to 17 years (average age 9.2 years; half girls, half boys) with moderate eczema. They were grouped by sex, age, and when their eczema started. Kids were excluded if they'd taken strong immune drugs in the last 3 months, antibiotics in the last 2 weeks, or had gut diseases or infections.
How long: 12 weeks, with check-ins to track progress.
What they took: One daily capsule with 1 billion colony-forming units (a measure of live bacteria) total from three probiotic strains—Bifidobacterium lactis CECT 8145, Bifidobacterium longum CECT 7347, and Lactobacillus casei CECT 9104—mixed with maltodextrin (a safe filler). The placebo was just maltodextrin capsules.

The trial is registered as NCT02585986 on ClinicalTrials.gov.

What This Means for You

If your child has moderate eczema, this study suggests a probiotic blend with Lactobacillus casei might help lessen symptoms like itching and redness, potentially cutting down on steroid cream use. Probiotics are "good" bacteria that support gut health, and here they seemed to calm skin inflammation from the inside out.

Talk to your pediatrician before starting probiotics— they can recommend safe, strain-specific options to pair with eczema creams or baths.
Look for supplements with similar strains (like L. casei CECT 9104) from trusted brands, but remember this was a mix, so single-strain effects aren't clear yet.
It could mean fewer flare-ups and less worry about steroid side effects, like skin thinning, but it's not a cure—use it as part of a full plan including moisturizers and avoiding triggers like allergens.
For parents searching "probiotics for kids eczema," this backs up trying them under medical guidance, especially for ages 4-17.

Study Limitations

No study is perfect, and this one has some caveats to keep in mind so you don't overhype the results.

Small group: Only 50 kids, so it might not apply perfectly to everyone—bigger studies could confirm this.
Combo effect: The benefits came from three bacteria together, so we don't know how much Lactobacillus casei alone helps.
Short time frame: Just 12 weeks, so long-term effects (like if benefits last after stopping) aren't known.
Specific setting: Done in one Spanish clinic with mostly European kids, so results might differ for other ages, ethnicities, or places with different diets or environments.
Missing details: It didn't check gut bacteria changes or immune responses, so the "why" behind the improvements isn't fully explained.

Overall, this is encouraging but calls for more research. Always check with a doctor for personalized advice on managing eczema.

Key Findings

The study demonstrated that daily oral administration of a probiotic mixture containing Lactobacillus casei CECT 9104 significantly reduced the SCORAD index (a measure of atopic dermatitis severity) by 19.2 points more than placebo over 12 weeks. Relative improvement was 83% in the probiotic group versus 24% in the placebo group (P < .001). Additionally, the probiotic group used topical steroids on 7.7% of patient-days compared to 10.8% in the placebo group (odds ratio: 0.63; 95% CI: 0.51–0.78), indicating reduced reliance on corticosteroids for flare management.

Study Design

This was a 12-week, randomized, double-blind, placebo-controlled clinical trial conducted in Spain. Participants included 50 children (26 females, 24 males; mean age 9.2 ± 3.7 years) with moderate atopic dermatitis. Groups were stratified by sex, age, and age of onset. Exclusions applied for recent immunosuppressive drug use, antibiotics, intestinal bowel disease, or bacterial infections.

Dosage & Administration

The intervention was a daily capsule containing 10⁹ colony-forming units (CFU) each of Bifidobacterium lactis CECT 8145, B. longum CECT 7347, and L. casei CECT 9104, with maltodextrin as a carrier. Placebo capsules contained only maltodextrin. Participants took one capsule daily for 12 weeks.

Results & Efficacy

SCORAD Index: Probiotic group showed a mean reduction of 19.2 points greater than placebo (95% CI: -15.0 to -23.4; P < .001). Relative improvement was -83% (CI: -95% to -70%) vs. -24% (CI: -36% to -11%) in placebo.
Topical Steroid Use: Probiotic group used steroids on 161 of 2,084 patient-days (7.7%) vs. 220 of 2,032 (10.8%) in placebo (OR: 0.63; 95% CI: 0.51–0.78).
Safety: No adverse events reported, suggesting the probiotic blend was well-tolerated.

Limitations

Small Sample Size: Only 50 participants limit statistical power and subgroup analysis.
Combination Effect: Results reflect a multi-strain probiotic mixture, so individual contributions of L. casei cannot be isolated.
Short Duration: 12-week follow-up may not capture long-term efficacy or safety.
Population Specificity: Conducted in a single Spanish clinic; generalizability to other demographics or regions is uncertain.
Mechanistic Gaps: No data on gut microbiota changes, immune markers, or sustained benefits post-intervention.

Clinical Relevance

This trial suggests that a probiotic blend including L. casei may serve as an adjunct therapy for pediatric moderate atopic dermatitis, reducing symptom severity and steroid dependence. However, the combination formulation necessitates further research to determine the efficacy of individual strains. Clinicians and caregivers might consider probiotics as a safe option to complement standard care, though larger trials are needed to confirm these findings and establish optimal dosing strategies. For supplement users, the study highlights potential benefits of multi-strain probiotics but underscores the importance of strain specificity and medical supervision in managing chronic skin conditions.

Study Identifier: NCT02585986 (ClinicalTrials.gov)
Source: PubMed (2018)